MEDICARE: TODD ALLEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VX0000X	Obstetrics Physician	26063	SC

General Provider Information

NPI Number	:	1063492494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD ALLEN MD

Provider Business Mailing Address
First Line	:	400 CONSTANCE ST
Second Line	:
City	:	WALTERBORO
State	:	SC
Zip	:	29488-2710
Country	:	US
Telephone Number	:	734-355-9871
Fax Number	:

Provider Business Practice Location Address
First Line	:	18181 OAKWOOD BLVD
Second Line	:	SUITE 200
City	:	DEARBORN
State	:	MI
Zip	:	48124-5032
Country	:	US
Telephone Number	:	313-593-5810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	01/04/2022

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Directions to “ TODD ALLEN MD” Practice Location

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